Mouthwash, mouth rinse, oral rinse or mouth bath, is a liquid which is held in the mouth passively or swilled around the mouth by contraction of the perioral muscles and/or movement of the head, and may be gargled, where the head is tilted back and the liquid bubbled at the back of the mouth.
Usually mouthwashes are antiseptic solutions intended to reduce the microbial load in the oral cavity, although other mouthwashes might be given for other reasons such as for their analgesic, anti-inflammatory or anti-fungal action. Additionally, some rinses act as saliva substitutes to neutralize acid and keep the mouth moist in xerostomia (dry mouth). Cosmetic mouth rinses temporarily control or reduce bad breath and leave the mouth with a pleasant taste.
Common use involves rinsing the mouth with about 20 ml (2/3 fl oz) of mouthwash. The wash is typically swished or gargled for about half a minute and then spat out. Most companies suggest not drinking water immediately after using mouthwash. In some brands, expectorate is stained, so that one can see the bacteria and debris.
Mouthwash should not be used immediately after brushing the teeth so as not to wash away the beneficial fluoride residue left from the toothpaste. Similarly, the mouth should not be rinsed out with water after brushing. Patients were told to “spit don’t rinse” after tooth brushing as part of a National Health Service campaign in the UK.
Gargling is where the head is tilted back, allowing the mouthwash to sit in the back of the mouth while exhaling, causing the liquid to bubble. Gargling is practiced in Japan for perceived prevention of viral infection. One commonly used way is with infusions or tea. In some cultures, gargling is usually done in private, typically in a bathroom at a sink so the liquid can be rinsed away.
Benefits and side effects
The most common use of mouthwash is commercial antiseptics, which are used at home as part of an oral hygiene routine. Examples of commercial mouthwashes companies include Cēpacol, Colgate, Corsodyl, Dentyl pH, Listerine, Odol, Oral-B, Sarakan, Scope, Tantum verde, and Biotene. Mouthwashes combine ingredients to treat a variety of oral conditions. Variations are common, and mouthwash has no standard formulation so its use and recommendation involves concerns about patient safety. Some manufacturers of mouthwash state that antiseptic and anti-plaque mouth rinse kill the bacterial plaque that causes cavities, gingivitis, and bad breath. It is, however, generally agreed that the use of mouthwash does not eliminate the need for both brushing and flossing. The American Dental Association asserts that regular brushing and proper flossing are enough in most cases, in addition to regular dental check-ups, although they approve many mouthwashes. For many patients, however, the mechanical methods could be tedious and time-consuming and additionally some local conditions may render them especially difficult. Chemotherapeutic agents, including mouth rinses, could have a key role as adjuncts to daily home care, preventing and controlling supragingival plaque, gingivitis and oral malodor.
Minor and transient side effects of mouthwashes are very common, such as taste disturbance, tooth staining, sensation of a dry mouth, etc. Alcohol-containing mouthwashes may make dry mouth and halitosis worse since it dries out the mouth. Soreness, ulceration and redness may sometimes occur (e.g. aphthous stomatitis, allergic contact stomatitis) if the person is allergic or sensitive to mouthwash ingredients such as preservatives, coloring, flavors and fragrances. Such effects might be reduced or eliminated by diluting the mouthwash with water, using a different mouthwash (e.g. salt water), or foregoing mouthwash entirely.
Prescription mouthwashes are used prior to and after oral surgery procedures such as tooth extraction or to treat the pain associated with mucositis caused by radiation therapy or chemotherapy. They are also prescribed for aphthous ulcers, other oral ulcers, and other mouth pain. Magic mouthwashes are prescription mouthwashes compounded in a pharmacy from a list of ingredients specified by a doctor. Despite a lack of evidence that prescription mouthwashes are more effective in decreasing the pain of oral lesions, many patients and prescribers continue to use them. There has been only one controlled study to evaluate the efficacy of magic mouthwash; it shows no difference in efficacy among the most common formulation and commercial mouthwashes such as chlorhexidine or a saline/baking soda solution. Current guidelines suggest that saline solution is just as effective as magic mouthwash in pain relief or shortening of healing time of oral mucositis from cancer therapies.
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